Anatomy of Outrage: On the Obamacare Resistance

By

September 20, 2013

Senator Ted Cruz speaks at a news conference with conservative congressional Republicans who persuaded the House leadership to include defunding the Affordable Care Act legislation to prevent a government shutdown. (AP Photo/J. Scott Applewhite)

The House of Representatives voted this morning for a short-term spending bill that would strip all funding for Obamacare, pushing the government down an uncertain path toward shutdown. Next, Republicans will refuse to raise the debt ceiling unless the law is gutted.

These moves won’t have any real effect on Obamacare, and they come against the judgment of party leaders and public opinion. President Obama won’t sign either piece of legislation even if it passes the Senate. Far more threatening to healthcare reform is the aggressive, localized campaign to sabotage the law’s implementation.

The fracas in Washington will probably cost the Republican Party far more than anyone else. Meanwhile, it’s making a lot of money for the conservatives who started it all.

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On a Thursday evening in late August, in the ballroom of a Double Tree hotel outside Wilmington, Delaware, Texas Senator Ted Cruz’s father Rafael rallied a few hundred conservatives to his son’s chief cause, the dismantling of the Affordable Care Act. “They can take our lives, they can take our fortunes,” the Cuban-born pastor shouted, wagging a finger at the crowd, which whistled and cheered. “But they cannot take our honor! No one can take our honor.”

It was the last stop of the Heritage Action Fund’s Defund Obamacare tour, a nine-city whipping-up of Tea Party fury designed to pressure congressional Republicans into a budget showdown over the health care law. Former Senator Jim DeMint, now the head of the Heritage Foundation, impressed upon the crowd the need to break the law before October 1, when the insurance exchanges open for enrollment. “If there’s ever been anything worth fighting for in the political arena, it’s this,” he said. “This is our time to stop it…. This is a winnable battle.”

His crusade seemed quixotic then. Only a handful of conservative members of Congress had signed the pledge to walk away from any spending bill or debt-ceiling deal that left Obamacare intact. Party leadership dismissed the Defunders, wary of being blamed for a government shutdown or a default. “Do you want to risk the full faith and credit of the US government over Obamacare?” House Speaker John Boehner asked in March. “That’s a very tough argument to make.”

Outside the Double Tree, a small group smoking cigarettes around a trashcan was more optimistic. “I think everybody that was there is motivated to do something,” mused a woman named Pat. “We’re losing the country.” They felt they were losing the Republican Party, too. “They’re weenies,” a man named Joe said about the leaders. “They’re really Democrats called Republicans,” Pat added. Joe again: “Democrat-lites.” He paused to consider. “They’re French Republicans!”

Two weeks later, spines in Washington have stiffened—really, they’ve bowed to the hard right. Boehner was forced to withdraw a short-term spending bill with a nonbinding rider that stripped funding from Obamacare when conservatives balked at a vote they said was merely symbolic. It’s no surprise House Republicans are tired of such gestures, after voting more than forty times to repeal or delay the law with nothing to show but a cost upwards of $50 million to taxpayers. The continuing resolution that passed the House on Friday defunds the healthcare law, and Republicans will now set to work on a bill to raise the debt ceiling for another year’s worth of borrowing, contingent also upon the demise of the ACA, as well as expedited construction of the Keystone XL pipeline and other Democratic non-starters.

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Neither bill can pass the Senate, much less the White House, and so without compromise from House Republicans the government is headed for a shutdown on October 1. More alarming is the prospect of a default, an unprecedented event that could roil the global economy. While this brinkmanship jeopardizes the country’s economic stability, it poses virtually no threat to Obamacare. With polling indicating that most Americans would blame Republicans for the shutdown, the White House has no reason to blink.

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The Defund Obamacare movement represents irresponsible governing at its apex, but what’s insidious about the whole show is the way it distracts from the actual threat to healthcare reform: the efforts to cripple the law’s implementation, led by Republican-controlled state governments and a range of right-wing PACs.

Sixteen states have imposed unnecessary restrictions on “navigators,” a workforce drawn from nonprofit and government agencies to educate consumers about their options and walk them through the new system. Twenty-one states have refused to expand Medicaid, which was intended to cover 17 million uninsured, low-income Americans. Officials in Missouri have been barred from doing anything to implement the law. A handful of other states are refusing to enforce its consumer protections, most critically the provision that bans insurers from rejecting applicants with preexisting conditions.

At the center of the “Obamacare resistance” is a media campaign to discourage young people from signing up for the exchanges. In order for the economics to work, the costs of adding unhealthy people to the insurance pool must be offset by premiums paid by the healthy. With only six in ten people aware of the exchanges and some 2.7 million young enrollees needed next year for the program to work, the administration has committed millions to reach young adults and get them enrolled. Earlier this year conservatives harassed organizations partnering with Health and Human Services on public-awareness campaigns; now they’re targeting young Americans directly.

Koch-funded Generation Opportunity launched a web series on Thursday as part of a six-figure campaign designed, in the words the nonprofit’s president Even Feinberg, “to communicate, ‘No, you’re actually not required to buy health insurance.’ You might have to pay a fine, but that’s going to be cheaper for you and better for you.” In one video, a leering Uncle Sam pops up between the legs of a young woman who has recently signed up for Obamacare and is reclining on the examining table, waiting for a pap smear. “Don’t let government play doctor,” the text reads, as Uncle Sam ratchets out the forceps, “Opt out of Obamacare.” Tinged with sexual violence, the ad is rich in irony, coming from the party that aggressively “plays doctor” to women across the country and isn’t exactly sure what rape is.

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Generation Opportunity will tour twenty college campuses this fall, dogging nonprofits like Enroll America that are signing up young Americans. A slew of other organizations are working in tandem, including FreedomWorks, which encourages college students to burn Obamacare “draft cards,” and YG Network, which ran an anti-Obamacare ad on Saturday Night Live. Just like the assault on women’s health providers, these attempts to convince young people that being uninsured is “better for you” are dangerous. Young adults are the people least likely to have insurance, and unexpected health emergencies can be financially crippling. Under Obamacare, subsidies will dramatically lower the cost of coverage, to as little as $5 a month for some 21-year-olds in California. Other provisions will give young people access to essential preventative services, with no copay—like the gynecological exam denigrated in the Generation Opportunity ad.

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Those discouraged or prevented from obtaining insurance will be the collateral damage of the Obamacare wars. Complication and confusion will continue to trouble the rollout, but it would take a mass panic across insurers, customers and legislators to bury the law. The loser, then, will be the Republican Party, which has staked its entire identity on opposition to healthcare reform. Once benefits begin to flow on January 1, it will be politically impossible to take them away. Without Obamacare, what is the GOP?

Capitulation to the repeal coalition signifies a rejection of the lesson in demographics offered by the 2012 election. Millennials didn’t fall for the conservative ads targeted at them then, and polls suggest they want insurance now. The people gunning for the healthcare law are mainly old and white, as the crowd packed into the ballroom in Wilmington suggested. Out in the parking lot, a tall African-American man told me that “hot air” was all he’d heard inside. “There’s no way the conservative party is going to be a nationwide party with the crowd that showed up tonight. I mean, I’m probably the youngest person in here.” He didn’t mention that he was probably the only person of color in the room, too. “This crowd here—I cannot vote Republican,” he went on. “This tonight is people who lost an election, and this man [DeMint] is selling them snake oil.”

Selling is right. Heritage Action and other PACs are profiting from the attacks on their own party by riling up rank-and-file Obamacare haters and picking their pockets to fund an unwinnable campaign. The Senate Conservatives Fund, a former DeMint project, raised more than $1.5 million in August, mostly from small donors, “the largest-ever monthly small-donor total brought in” by the group, according to The Huffington Post. Daily e-mails from Heritage feature a large red “Donate” button. The millions of signatures collected on the online petitions give the PACs a network to plumb for future causes, or candidates: Ted Cruz’s election campaign was bankrolled by the Senate Conservatives Fund in 2012.

“These organizations, ensconced in Northern Virginia office parks and elsewhere, aren’t worried about the establishment’s ire,” wrote National Review’s Bob Costa. “In fact, they welcome it. Business has boomed since the push to defund Obamacare caught on. Conservative activists are lighting up social media, donations are pouring in and e-mail lists are growing.” Brian Walsh, a former spokesperson for the National Republican Senatorial Committee, explained, “Money begets TV ads which begets even more money for these groups’ personal coffers. Pointing fingers and attacking Republicans is apparently a very profitable fundraising business.”

Rafael Cruz was right when he cried out to the Wilmington crowd, “They cannot take our honor!” The Obamacare opposition has no honor left to take.